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HIV and Injection Drug Use

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Overview

Sharing needles, syringes, and other injection equipment puts people who inject drugs (PWID) at high risk for getting HIV and other infections, including hepatitis. Annual HIV diagnoses among black and Hispanic/Latino PWID were cut in half between 2008–2014, but diagnoses among white PWID dropped by only 28%. One reason may be that fewer blacks and Hispanics/Latinos are sharing needles and syringes, while whites are more likely to share them. Syringe services programs (SSPs) can play a role in preventing HIV and other health problems among PWID. They provide access to sterile syringes and should also provide comprehensive services such as help with stopping substance misuse; testing and linkage to treatment for HIV, hepatitis B, and hepatitis C; education on what to do for an overdose; and other prevention services. State and local health departments can work with their lawmakers and law enforcement to make SSPs more available to PWID.

State and local health departments can:

Use data on HIV, hepatitis, substance use, and overdoses to determine where services are needed.

Work with law enforcement and local leaders to expand access to SSPs, where permitted by law.

Provide HIV and hepatitis testing and prevention services for PWID.

Ensure treatment is available for overdoses, HIV, hepatitis, and substance use disorder, and inform first responders about available resources.

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What Can Be Done

The Federal government is

Allowing certain state and local prevention programs to use their federal funds for SSPs (not to buy needles, syringes, and other injection equipment). For more information, visit http://bit.ly/2eVU8ab.

Providing support and access to HIV, hepatitis, and substance use disorder prevention and treatment, including medication-assisted treatment and mental health services.

State and local health departments can

Use data on HIV, hepatitis, substance use, and overdoses to determine where services are needed.

Work with law enforcement and local leaders to expand access to SSPs, where permitted by law.

Provide HIV and hepatitis testing and prevention services for PWID.

Ensure treatment is available for overdoses, HIV, hepatitis, and substance use disorder, and inform first responders about available resources.

Healthcare providers can

Screen patients for substance use disorder, including the misuse of prescription opioids. Provide or link PWID to medication-assisted treatment, and link them to mental health services, if needed. Use CDC opioid prescribing guidelines, http://bit.ly/1jTLLej

Test PWID for HIV and hepatitis and treat them if they are infected. Vaccinate patients for hepatitis A and B, if appropriate.

Prescribe sterile syringes to PWID, or refer them to SSPs or pharmacies that provide sterile syringes, where permitted by law.

Prevent overdose deaths by providing naloxone or referring PWID to pharmacies or community-based programs that provide it, where permitted by law.

Lawmakers, judges, police and other criminal justice officials can

Address legal and law enforcement barriers that prevent or discourage the use of SSPs and substance use disorder treatment, including use of medication-assisted treatment.

Refer PWID to substance use disorder treatment and HIV and hepatitis prevention services.

Support HIV and hepatitis testing and care and hepatitis vaccination in prisons and jails.

People who inject drugs can

Get help to stop injecting drugs. SAMHSA.gov, or 1-800-662-HELP (4357).

Use only new, sterile syringes, safely dispose of used syringes, and never share any equipment if injecting drugs. Contact the local health department or NASEN.org to find an SSP.

Get tested for HIV and hepatitis C at least once a year. Get vaccinated for hepatitis A and B if not infected. People who have HIV or hepatitis should get medical care and take medicines as prescribed.